The use of custom implants for total knee arthroplasty

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  • Considerations and techniques for custom total knee arthroplasty
  • What does this look like in reality? Is custom total knee arthroplasty superior to traditional alignment methods?
  • Future perspectives
  • Conclusion

Part 1 | Evolution of alignment concepts

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Part 2 | Robotic-assisted total knee arthroplasty

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Contributing experts

This series of articles was created with the support of the following specialists (in alphabetical order):

Michel Bonnin

Centre Orthopédique Santy
Lyon, France

Sébastien Lustig

Lyon North University Hospital
Lyon, France

Charles Rivière

Clinique du Sport Bordeaux-Mérignac
Mérignac, France

This issue was written by Antia Rodriguez-Villalon and Laura Kehoe, AO Innovation Translation Center, Clinical Science, Switzerland.

References

  1. Hirschmann MT, Hess S, Behrend H, et al. Phenotyping of hip-knee-ankle angle in young non-osteoarthritic knees provides better understanding of native alignment variability. Knee Surg Sports Traumatol Arthrosc. 2019 May;27(5):1378–1384.
  2. Hirschmann MT, Moser LB, Amsler F, et al. Phenotyping the knee in young non-osteoarthritic knees shows a wide distribution of femoral and tibial coronal alignment. Knee Surgery, Sports Traumatology, Arthroscopy. 2019 2019/05/01;27(5):1385–1393.
  3. Moser L, Hess S, Behrend H, et al. Functional knee phenotypes - A novel classification for the lower limb alignment based on the native alignment in young non-osteoarthritic patients. Orthopaedic Journal of Sports Medicine. 2020;8(5_suppl4):2325967120S2325900301.
  4. Bonnin MP, Basiglini L, Archbold HA. What are the factors of residual pain after uncomplicated TKA? Knee Surg Sports Traumatol Arthrosc. 2011 Sep;19(9):1411–1417.
  5. Meding JB, Wing JT, Ritter MA. Does high tibial osteotomy affect the success or survival of a total knee replacement? Clin Orthop Relat Res. 2011 Jul;469(7):1991–1994.
  6. Rivière C, Lazic S, Boughton O, et al. Current concepts for aligning knee implants: patient-specific or systematic? EFORT Open Rev. 2018 Jan;3(1):1–6.
  7. Park A, Duncan ST, Nunley RM, et al. Relationship of the posterior femoral axis of the "kinematically aligned" total knee arthroplasty to the posterior condylar, transepicondylar, and anteroposterior femoral axes. Knee. 2014 Dec;21(6):1120–1123.
  8. Bonnin MP, Beckers L, Leon A, et al. Custom total knee arthroplasty facilitates restoration of constitutional coronal alignment. Knee Surgery, Sports Traumatology, Arthroscopy. 2022 2022/02/01;30(2):464–475.
  9. Sappey-Marinier E, Tibesku C, Selmi TAS, et al. Custom Total Knee Arthroplasty. In: Rivière C, Vendittoli PA, ed. Personalized Hip and Knee Joint Replacement. Cham (CH): Springer Copyright 2020, The Author(s). 2020. 255-264.
  10. Daxhelet J, Aït-Si-Selmi T, Müller JH, et al. Custom TKA enables adequate realignment with minimal ligament release and grants satisfactory outcomes in knees that had prior osteotomies or extra-articular fracture sequelae. Knee Surg Sports Traumatol Arthrosc. 2021 May 27.
  11. Ratano S, Müller JH, Daxhelet J, et al. Custom TKA combined with personalised coronal alignment yield improvements that exceed KSS substantial clinical benefits. Knee Surg Sports Traumatol Arthrosc. 2022 Sep;30(9):2958–2965.
  12. Moret CS, Hirschmann MT, Vogel N, et al. Customised, individually made total knee arthroplasty shows promising 1-year clinical and patient reported outcomes. Arch Orthop Trauma Surg. 2021 Dec;141(12):2217–2225.
  13. Victor J, Vermue H. Custom TKA: what to expect and where do we stand today? Arch Orthop Trauma Surg. 2021 Dec;141(12):2195–2203.